Recently, arterial catheter examinations have been made for contrast medium-using diagnosis of hearts or cerebral blood vessels. Cardiac catheter examinations are made by surgical operation in a few cases but in most cases by the so-called catheter puncture method which moves a catheter from the femoral artery or vein in the inguinal region to the heart. In this examination method, a contrast medium or various medicines are injected through the catheter puncturing the femoral artery or vein in the inguinal region or various preoperative and postoperative examinations are conducted. In this connection, there is a need to compress the catheter insertion wound for a relatively long time in order to stop bleeding from the catheter insertion wound owing to extraction of the catheter from the femoral artery or vein in the inguinal region. Compressive hemostatic methods using adhesive plasters or stretchable belts (see Japanese Patent Application Disclosure Nos. 92746/1985 and 198139/1985) have heretofore been proposed as compressive hemostatic means for such wounds. In the former method, a gauze is applied to the wound and 3 or 4 fabric adhesive plasters are applied to said gauze to compress the wound from above the gauze and a sand bag having a controlled weight of 500-1000 g is placed on said adhesive plasters, said sand bag being fixed in position by adhesive plasters and maintained in this state for 12-24 hours. In this method, however, the sand bag tends to deviate from the region to be compressed, resulting in incomplete hemostasis. Further, the use of adhesive plasters causes such drawbacks to the patient as a stiffening feel, pain and itch and favors the development of skin inflammation and blisters. On the other hand, in the latter method, which uses a stretchable belt, the way of wrapping the belt is complicated and the resulting compressive load is unstable. Further, the use of stretchable belts leads to high cost and they can hardly be thrown away after single use in spite of the fact that reuse involves a hygienic problem of causing hemoinfectious diseases. Therefore, they must be sterilized for prevention of hemoinfectious diseases before they can be reused, imposing limitations not only from a hygienic standpoint but also from the standpoint of enhancing labor saving for nurses.
With the above problems in mind, I have proposed, in Japanese Patent Application No. 20793/1992, a compressive hemostatic belt shown in FIG. 36, as means for stopping bleeding from a wound. This compressive hemostatic belt comprises a pocket 122 in a predetermined position on a band 121 made of non-stretchable or low-stretchable fiber or film, a rigid case 123 and a balloon 124 which are received in said pocket 122. The rigid case 123 is a rigid member made of synthetic resin or the like in bowl form. Further, the balloon 124 is made of rubber or the like and received in the rigid case 123 with a fluid feed tube 126 having a check valve 125 in the pocket 122 and projecting outside. The fluid feed tube 126 for the balloon 124 will have a manual pump 127 and a pressure gauge 128 connected thereto according to the need. Looking at the pressure gauge 128, the operator operates the pump 127, whereby fluid is fed through the fluid feed tube 126 to fill the balloon 124 so that the latter is inflated.
A description of the way of using the compressive hemostatic belt described above will now be given.
As shown in FIG. 37, a gauze B is applied to a catheter insertion wound A and the pocket 122 having the rigid case 123 and balloon 124 received therein is placed on said gauze with the open side of the rigid case 123 directed to the gauze B, whereupon, as shown in FIG. 38, the band 121 is wrapped around the patient's body. That is, the band 121 is wrapped around the leg to cross itself in X-form and the remaining portion is wrapped around the patient's waist one or more turns, the free end being fixed in position by an adhesive plaster. Thereafter, the operator connects the manual pump 127 and pressure gauge 128 to the fluid feed tube 126 of the balloon 126 and, looking at the pressure gauge, operates the pump 127 to fill the balloon 124 with fluid. As shown in phantom lines in FIG. 37, the balloon 129 is inflated against the wound A with the rigid case 123 limiting its inflation to the opposite side, thereby compressing the wound A via the gauze B, the band 121 being firmly fixed to the patient.
Since the above compressive hemostatic belt compresses the wound A by utilizing the inflation of the balloon 124 in the manner described above, it is possible to compress the wound A alone with no compressive feeling transmitted to the other parts of the patient's body. Operating the pump 127 while looking at the pressure gauge 128 allows the selection of the desired size of the compressive force to be applied to the wound A. The selected compressive force being applied to the wound A can be maintained for a long time by the check valve 125. Since a non-stretchable or low-stretchable fabric is used for the band 121, the occurrence of a stiffening feel, pain or itch can be avoided and so can skin inflammation and blisters. Further, the belt can be presented at low cost and thrown away after single use. Other remarkable effects are also developed in respect of improvements in hygiene and enhanced labor saving.
Since the conventional compressive hemostatic belt has its band 121 made in straight form, the fitness of the belt as wrapped in X form around the leg is poor, producing positional deviation or slack during a lone period of compressive hemostasis, resulting in unsatisfactory compression of the wound. The portions of the belt wrapped around the patient's leg and waist tend to form wrinkles, thus developing an uncomfortable feeling in the patient and positional deviation or slack is produced by wrinkles or twist, making it difficult to provide a stabilized compressive force. Further, the end of the band 121 is locked by locking means, such as a double-coated tape or magic tape. Such double-coated tapes or magic tapes tend to decrease their adhesive power during repeated use. There is a danger of the band slacking or coming off during wearing. Since the position where the locking means is fastened differs from patient's figure to figure, several bands different in length have to be prepared according to patients' figures.
I have proposed, in Japanese Patent Application No. 153155/1993, a compressive hemostatic belt which remedies the drawbacks described above. This belt includes a rotatable buckle having slits in the opposite sides and integral with the band and the rigid case having the balloon received therein. Band holding jigs are installed on the opposite sides of the buckle. Each jig comprises a fixed portion extending integrally from the buckle and a movable portion rotatably supported on the fixed portion. The movable portion has a cross section which is asymmetrical with respect to its axis of rotation and the clearance between the movable and fixed portions is increased when the band is passed, said clearance disappearing when the band is fixed in position. According to this compressive hemostatic belt, since the ends of the band are locked by utilizing the band holding jigs, effective compressive hemostasis is achieved without the danger of the band coming off or slacking during wearing. Further, any desired portions of the band can be locked by the jigs; therefore, if the remaining excessive portion, if any, of the band is cut off by scissors, a single type of band which is a little longer in size can be applied to almost all patients.
However, when the ends of the band of said compressive hemostatic belt are to be locked, the ends of the band have to be passed through the slits of the buckle and turned back to pass between the movable and fixed portions of the band holding jigs. Since the buckle and band holding jigs are integrally attached to the rigid case, said operation is hard to perform, retarding the wrapping operation or leading to troubles.
Another problem is that since the band 121 which is made of non-stretchable or low-stretchable fiber, nonwoven fabric or film is wrapped around the body, which is undulating or wavy, the band 121 tends to float off the skin when the leg is raised, leading to poor fitness. As a result, when the compressive hemostasis continues for a long time, the band wrinkles or twists to arouse an uncomfortable feeling in the patient and such wrinkles or twist causes positional deviation or slack, thus making the compression of the wound insufficient.
In the compressive hemostatic belt described above, a check valve is attached to the outer end of the fluid feed tube 126 in order to hold the fluid in the balloon 124 for a long time. Since this check valve 125 should have a holding power of more than 24 hours, it is made in precision construction in consideration of reliability, leading to a high cost. Thus, the cost of the check valve 125 is high and if this compressive hemostatic belt is thrown away after single use, it becomes expensive and is disadvantageous from an economic point of view.
The check valve 125 has to be constructed to allow fluid to flow in and out. However, the check valve 125 constructed to allow fluid to flow in and out is complicated in construction and expensive, leading to an increase in the cost of the compressive hemostatic belt and making it uneconomical to throw away the belt after single use. Further, the check valve constructed to allow fluid to flow in and out does not allow fluid to flow out in the state in which the connecting hose of the fluid flow in-and-out pump 127 is connected. Thus, when the fluid is pumped into the balloon 124 by the fluid flow in-and-out pump 127, the compressive force can be ascertained by the pressure gauge 128, but it cannot be ascertained when the fluid flows out of the balloon 124. Thus, adjustment of the compressive force has been very inconvenient.
An object of the present invention is to provide a compressive hemostatic belt having improved fitness on the body, prevented from wrinkling or twisting, and designed so that the band can be easily wrapped and the ends of the band can be easily locked.
Another object of the invention is to provide a compressive hemostatic belt prevented from coming off or slacking after being wrapped and wherein a single type is sufficient for all band lengths.
Another object of the invention is to provide a compressive hemostatic belt which is sufficiently inexpensive to be advantageously thrown away after single use.
A further object of the invention is to provide a compressive hemostatic belt designed for convenient adjustment of compressive force and a fluid flow in-and-out pump for use with it.